Chemsex in Focus: What’s Missing in Research and Prevention

Chemsex, a term referring to the use of drugs during sex, has mainly been tied to men who have sex with men (MSM). It’s now a health concern because it’s linked to rising rates of sexually transmitted infections (STIs) and HIV. But there’s more to explore than just MSM. Let's dive into what research has been done and if it's enough. A study examined if most research on chemsex centered around MSM and whether it considered other sexual orientations and gender identities. They also looked at prevention and risk reduction strategies, excluding HIV prevention methods like pre- and post-exposure prophylaxis. Using the PRISMA guidelines, they searched databases like Cochrane Library, PubMed/MEDLINE, Scopus, and Web of Science from April to July 2024. The first search dug up 1314 studies, out of which 14 were relevant. These studies covered chemsex in various groups based on sexual orientation and gender identity, painting a broad picture of the issue. The second search found 1985 studies, but only two met the criteria. Interestingly, no primary or secondary prevention interventions were found, but risk reduction programs were. These programs showed that they could decrease chemsex practices, unsafe sex, and substance use. Chemsex is complex and reflects the dynamics within sexually diverse groups. Gender, sexual orientation, and group insecurities play a role. While risk reduction exists, primary prevention is lacking. To truly tackle this, research should expand to include all populations, and strategies need to be inclusive.